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Biomedical subjects

L A Mollinger

Publications and source records attributed to L A Mollinger.

18 recordsLinked to original sources
PubMed1995

Low-load, prolonged stretch in the treatment of knee flexion contractures in nursing home residents.

BACKGROUND AND PURPOSE: The purpose of this study was to do a pilot test of the effectiveness of prolonged stretch (use of splint) in reducing knee flexion contractures more than a traditional program of passive range of motion (PROM) in a group of nursing home residents. SUBJECTS: The subjects were 28 nursing home residents with 10 degrees or more of knee flexion contracture bilaterally. Eighteen subjects completed the study. METHODS: Data were collected prior to the initiation of the intervention and at monthly intervals during the 6 months of treatment. Repeated measurements were made of hip, knee, and ankle range of motion (ROM); the torque required to maintain passive impairment. knee extension; knee pain; several indicators of function; and cognitive impairment. Both legs of each subject received PROM and manual stretching twice a week; in addition, one leg was given a prolonged stretch (use of a splint) five times a week. RESULTS: There were no differences in knee ROM between the side that received prolonged stretching and the side that received only PROM and manual stretching at the beginning of the study. No differences in ROM or torque measurements existed between the side that received prolonged stretching and the side that received only PROM and manual stretching at any interval, nor in ROM or torque over time for either side. Because of the low statistical power of the study, the results should be viewed with caution. CONCLUSION AND DISCUSSION: Physical therapists need to question whether prolonged stretch for nursing home residents with knee flexion contractures greater than 10 degrees is of any greater benefit than PROM and manual stretching. Investigations of other treatment protocols and treatment doses are needed, including work in the area of prevention of knee flexion contractures. For the pilot group of nursing home residents studied, gains in knee extension did not occur with the use of prolonged stretch for 3 hours a day, 5 days per week. [Steffen TM, Mollinger LA. Low-load, prolonged stretch in the treatment of knee flexion contractures in nursing home residents.

Activities of Daily Living↗
PubMed1987

Function following partial fibulectomy.

The fibula is a valuable source of a bone graft, but because the fibula has a role in lower extremity function, it is important to determine whether partial removal results in dysfunction or other problems. Forty-one patients (48 +/- 10 years of age) had a portion of their fibula removed for a bone graft. At evaluation 27 +/- 8 months later, 24 had no pain, 11 mild pain, and six moderate or severe pain. Sixteen had no complaints of any kind, but four without pain had minor difficulties with vigorous activities, and three complained of ankle swelling. There were no differences in range of motion between the operated and nonoperated side. Average muscle torque was lower on the operated than on the nonoperated side, but this difference was statistically significant only for ankle evertors in men. This study demonstrates that most patients will have subjective complaints and mild muscular weakness after removal of a portion of the fibula.

Adult↗
PubMed1986

Comparison of function two years after revision of failed total hip arthroplasty and primary hip arthroplasty.

Because of the known high complication rate, it is important for both the patient and physician to know as much as possible about the outcome of revision operations for loosened total hip arthroplasties. This study evaluates the changes in subjective ratings and objective kinesiologic measurements from before revision operations through two years after revision operations. The object is to compare these measurements with the measurements of a group of patients with primary replacements. Both groups of patients showed significant improvement in most parameters from before to after surgery. These parameters included walking performance, hip muscle strength, range of motion, forces applied to canes, and the amount of weight borne on the operated limb during quiet standing. Compared to the control group with primary replacements, the group with revision used more assistive devices, had less pain relief, walked slower, had less hip motion, and had more lateral lurch. While results after revision surgery were not as gratifying as those after primary hip replacement, patients requiring revision can still anticipate substantial improvement.

Adult↗
PubMed1986

Strength and range of motion in the ankle in two age groups of men and women.

Strength and range of motion of the ankle were measured in 20 normal men and 20 normal women divided equally into two age groups (25-35 and 50-60 years). Total range of dorsiflexion/plantar flexion averaged 75 degrees and the total range of inversion/eversion averaged 28 degrees. Few significant differences in range of motion were found between age groups, between men and women, or between dominant and nondominant limbs. Mean torque values for the men were greater than those for the women for all four muscle groups tested (plantar flexors, dorsiflexors, invertors and evertors). Strength of the women ranged from 62 to 70 percent of that of the men, depending upon muscle group. A multiple regression analysis showed that after the variability in muscle strength due to height and lean body weight had been taken into account, the additional variance accounted for by gender was very small. Differences in torque between age groups were not statistically significant. Differences in strength between dominant and nondominant limbs were significant only for the plantar flexors and dorsiflexors of the men.

Adult↗
PubMed1985

Age-related differences in knee muscle strength in normal women.

This study provides normal baselines of knee muscle strength for women up to 86 years of age. Knee muscle strength (torque) was measured during maximum isometric and dynamic (isokinetic) contractions in 72 normal healthy women in three age groups between 20 and 86 years. Strength of the oldest group ranged from 56 to 78% of that in the youngest group, depending on knee joint position. Strength values were greater for isometric contractions than for isokinetic contractions (performed at 36 degrees per second) and were approximately twice as great for the extensor as for the flexor muscles. For both muscle groups, the torque generated with the knee in 30 degrees of flexion was usually lower than that generated with the knee at the 45- or 60-degree position. Despite the significant deficit found in the strength of the oldest group, it is likely that this relative weakness would not be detected on routine clinical examination using manual muscle testing.

Adult↗
PubMed1985

Treadmill vs. floor walking: kinematics, electromyogram, and heart rate.

To identify the degree of difference between treadmill and floor walking, kinematic, electromyographic (EMG), and heart rate measurements were recorded in seven normal female subjects during walking at three speeds on the treadmill and on the floor. During treadmill walking, subjects tended to use a faster cadence and shorter stride length than during floor walking. In addition the displacements of the head, hip, and ankle in the sagittal plane showed statistically significant differences between floor and treadmill walking. Average EMG activity was usually greater on the treadmill than on the floor; however, this difference was only significant for the quadriceps. Heart rate was significantly higher during fast treadmill walking than floor walking. In general, treadmill walking was not found to differ markedly from floor walking in kinematic measurements or EMG patterns.

Adult↗
PubMed1985

Functional performance after tibial rotationplasty.

We measured muscle strength, joint motion, and gait parameters and determined the electromyographic activities of the ankle and knee during walking, running, and stair-climbing in two children who had had a tibial rotationplasty for osteosarcoma of the distal end of the femur. Both had marked loss of strength in the plantar flexors on the side of the prosthesis compared with the sound side, although electromyographic recordings showed that the rotated calf muscles, to a substantial degree, had assumed the function of extensors of the prosthetic knee. Despite some abnormalities in gait, both children walked at speeds that were comparable to those of normal children. They could also run, climb stairs by stepping up with both limbs, and participate in many recreational activities. The functional abilities of these children suggested that rotationplasty, in patients with a similar lesion, is a worth-while alternative to above-the-knee amputation.

Artificial Limbs↗
PubMed1985

Daily energy expenditure and basal metabolic rates of patients with spinal cord injury.

Basal metabolic rate (BMR) and daily energy expenditure were measured in 48 men with complete traumatic transections of the spinal cord. Subjects were classified according to their residual motor function as high or low quadriplegic (HQ, LQ) or as high or low paraplegic (HP, LP). Measured BMR was lower than predicted BMR in almost all of the subjects and was significantly lower in the HQ group than in the other groups. High quadriplegics also expended significantly less energy while awake and over a 24-hour period than did the other groups. Measurements of BMR and total energy expenditure were significantly correlated with the level of lesion. The data provide a basis for establishing guidelines on the average energy needs of patients with spinal cord injury.

Adult↗
PubMed1985

Antalgic maneuvers during walking in men with unilateral knee disability.

The gait of men with unilateral knee disability has not been quantified previously. Interrupted-light photography was used to quantify the gait abnormalities of 35 men whose major disability was unilateral knee pain. The following antalgic maneuvers were found to be common to the gait of these patients: slow and uneven forward progression with lateral lurching toward the painful side, asymmetry in stride and temporal components, and abnormalities in the displacement patterns of most body segments. Subnormal knee motion was found during the stance and swing phases. Because treatment of patients with knee problems is usually directed toward pain relief, an understanding of how pain affects walking performance is important to the clinician when assessing a patient's problem.

Adult↗
PubMed1984

Kinematic and EMG patterns during slow, free, and fast walking.

Kinematics and electromyographic (EMG) activity were recorded in seven normal women during walking at slow, free, and fast speeds. Speed-related differences were found in the stride dimensions, temporal components, and most of the simultaneous displacement patterns of body segments measured. For most of the muscles tested, the amplitude of normalized EMG activity decreased as walking speed decreased. The findings emphasize the importance of accounting for the effect of speed itself on measurements of gait.

Adult↗
PubMed1983

Gait patterns in above-knee amputee patients: hydraulic swing control vs constant-friction knee components.

Multiple displacement patterns, stride dimensions, and temporal components during slow, free-speed, and fast walking were compared in the same seven above-knee amputees using prostheses with constant-friction knee components and using hydraulic swing-control knee components. During walking with the hydraulic-type prostheses, the amputees showed a wider range of walking speeds, improvement in the equality of the durations of successive swing and stance phases, and greater uniformity of forward progression. Improvements toward normal were also seen in several of the displacement patterns of the prosthetic limb during walking with the hydraulic knee. Several gait abnormalities persisted with both types of prostheses.

Adult↗
PubMed1981

Joint function after total hip arthroplasty: a four-year follow-up of 72 cases with Charnley and Müller replacements.

To help determine the duration of benefits in functional performance resulting from total hip arthroplasty (THA), multiple kinesiologic measurements were made before surgery and two and four years after 32 Charnley and 40 Müller THA procedures were done in 58 patients. There were no complications of loosening or infection, nor was there additional disability in other joints of the lower extremities. Measurements of functional performance included range of hip motion, hip abductor and adductor muscle strength, weight distribution between the feet during standing, forces applied to canes or crutches, and multiple components of free-speed and fast-walking performance. The average measurements showed significant improvement in almost all components of function from the time preceding surgery to two years afterward. The two-year level of function was then maintained without significant improvement or decline in function four years postoperation.

Adult↗
PubMed1980

Strength of isometric and isokinetic contractions: knee muscles of men aged 20 to 86.

Maximum isometric and isokinetic torques of the knee flexor and extensor muscles were measured at three knee joint positions in 72 normal, health men in three age groups from 20 to 86 years. The isokinetic contractions were performed at a speed of 36 degrees per second. The isometric contractions were sustained for five seconds. Strength of the men in the older age groups was significantly less than that of the youngest group. The strength of the isokinetic contractions was significantly less than that of the isometric contractions for all joint positions. The men in the oldest age group generally took longer than the younger men to reach peak torque during the isometric contractions. The torque values provide base-lines for evaluating patients with knee joint disabilities.

Adult↗
PubMedDate not supplied

Kinematic and electromyographic patterns of Olympic race walkers.

The performance of two Olympic race walkers was studied during free-speed, fast, and race walking. Measurements of the stride and temporal components of gait, as well as the simultaneous displacement patterns of the body segments, and the electromyographic activity of muscles of the trunk and upper and lower limbs were recorded during the three walking speeds. During the testing, the race walkers achieved an average speed of 12.5 km/hr as compared to the 8.7 km/hr average speed achieved by normal men of the same age during fast walking. Race walking was characterized by an increase in cadence and stride length beyond that of normal controls (in a prior study) during fast walking, with stride lengths averaging 125% of stature during race walking, and 115% during normal fast walking. In the two race walkers the amplitudes of most of the movement patterns of the trunk and upper and lower limbs were exaggerated during race walking as compared to normal controls' fast walking. Several mechanisms were used by the race walkers to minimize the vertical excursion of the center of gravity of the body during race walking. All of the muscles monitored in the race walkers showed an increase in the amplitude of electromyographic activity during race walking as compared to fast walking; duration of muscle activity was also usually increased during race walking. Several suggestions for prevention of injuries associated with race walking are made.

Adult↗
PubMedDate not supplied

Shoulder motion and muscle strength of normal men and women in two age groups.

Normal age- and sex-related standards for shoulder range of motion (ROM) and muscle strength are unavailable in the literature. Active range of shoulder motion and maximum isometric strength (torque) of several shoulder muscle groups were measured in normal healthy men and women between 25 and 36 and between 55 and 66 years of age. Values for joint motion were similar for the two age and sex groups. The strength of the women was 45% to 66% of that in men, and strength of the older subjects was 66% to 93% of that in younger subjects. Strength of the second attempt at contraction was greater than that of the first attempt. Arm dominance did not significantly affect strength values.

Adult↗